Changes in clinical crown height as a result of transverse expansion of the maxilla in adults

The risk of developing bony dehiscence and gingival recession may lead clinicians to prefer extraction to expansion in borderline cases. The purpose of this research was to compare changes in clinical crown height that occur at the buccal aspect of the maxillary lateral teeth of adult patients in which the transverse dimension was increased with those occurring if no expansion had been performed. Secondly it was the intention to identify factors increasing the risk of development of gingival recessions. The material comprised the pre- and post-treatment study casts from two groups of 50 adult patients. In one group an average transverse expansion of 3 mm was performed while in the other no change in the arch width was generated during treatment. Clinical crown heights of the two groups before and after treatment were compared with a Student's t-test and correlation analysis was used to determine whether any demographic or treatment-related parameters could be applied to predict an increase in clinical crown height. The increase in transarch width was greater in males (2.4-3.4 mm) than in females (1.8-2.5 mm), and greater at the level of the premolars than at the molars. No significant increase in buccal crown height could be identified. The increase in width was, however, related to buccal tipping as a positive correlation was found between the amount of expansion and tipping (P < 0.01). No detrimental effect of slow maxillary expansion could be demonstrated.